Clinical Updates on Bone-Sparing Therapies for Cancer-Related Bone Disease and
Osteoporosis

Release Date: February 14, 2011

Expiration Date: February 28, 2013

Estimated time to complete activity: 2.0 hours

Sponsored by
PHEcuratio


This activity is supported by an educational donation provided by
amgen

This CE-certified Web-based activity is based on information presented at a satellite symposium held on December 7, 2010 in Anaheim, California at the 45th American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting and Exhibition.

Hardware/Software Requirements

  • Javascript-enabled browser
  • Active Internet connection
  • Adobe Acrobat Reader
  • Adobe Flash Player plugin v.8.0+

Activity Overview

Loss of bone mass, which leads to fracture and other complications, is increasingly recognized as a major health care dilemma. Currently, over 10 million Americans have been diagnosed with osteoporosis and an additional 34 million have low bone mass. The increased risk of bone loss and fracture that is seen throughout the course of disease in people with cancer is equally concerning. Bone loss in cancer patients is generally more rapid and severe than bone loss associated with aging and menopause. Bone metastasis also increases bone loss, further increasing risk. Skeletal-related events, especially pathologic fracture, lead to severe pain, a dramatic decrease in quality of life, and substantially increased rates of morbidity and mortality. To ensure optimal management of patients at risk for skeletal complications due to bone loss, pharmacists must have a thorough understanding of bone pathophysiology and the treatment strategies for bone loss. This activity features discussions on the current and emerging therapies used to manage patients with osteoporotic and cancer-related bone loss.

Target Audience

This activity has been designed to meet the educational needs of health-system pharmacists, retail pharmacists, and other pharmacy professionals involved in the management of patients with bone disease.

Learning Objectives

Upon completion of this activity, participants should be able to:

  1. Describe the impact of untreated bone loss on fracture risk, overall health, and quality of life
  2. Recognize individuals at risk of bone loss and implement appropriate preventive therapy early in the course of treatment
  3. Discuss mechanisms of bone loss and new therapeutic approaches to managing bone loss
  4. Recommend appropriate screening methods and schedules to monitor for bone loss
  5. Apply current guidelines in the prevention and management of bone disease

Faculty

Laura Boehnke Michaud, PharmD, BCOP, FASHP—Activity Chair
Manager, Clinical Pharmacy Services
The University of Texas M. D. Anderson Cancer Center
Adjunct Assistant Professor of Pharmacy Practice
University of Houston, College of Pharmacy
Houston, Texas

Jill S. Burkiewicz, PharmD, BCPS, FCCP
Professor, Pharmacy Practice
Director, PGY1 Residency Program
Midwestern University Chicago College of Pharmacy
Downers Grove, Illinois

Jane M. Pruemer, PharmD, BCOP, FASHP
Professor of Clinical Pharmacy Practice
James L. Winkle College of Pharmacy
University of Cincinnati Medical Center
Oncology Clinical Pharmacy Specialist
University Hospital and the Barrett Cancer Center
Cincinnati, Ohio

Sarah L. Scarpace, PharmD, BCOP
Assistant Dean for Pharmacy Professional Affairs
Albany College of Pharmacy and Health Sciences
Albany, New York

Accreditation Statement

acpePostgraduate Healthcare Education is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education.
UAN: 0430-0000-11-002-H01-P
Credits: 2.0 hours (0.20 ceu)
Type of Activity: Knowledge
Fee Information: There is no fee for this activity.

Method of Participation

There are no fees for participating in this CE activity. To receive credit during the period January 26, 2011 to January 31, 2013, participants must (1) read the learning objectives and disclosure statements, (2) study the educational activity, and (3) complete the posttest and activity evaluation form, including the certificate information section.

To obtain a certificate, participants must receive a score of 70% or better on the posttest. The posttest can be accessed at the end of the activity. Please e-mail any questions to cecustomerservice@jobson.com.

Medium

This activity is offered as an Internet activity on the US Pharmacist Web site. Offering this CE activity online allows participants to learn on their own time and at their own pace. The interactive nature of the activity allows participants to become engaged and offers visual, written, and spoken education to suit many learning styles.

Disclosure

In accordance with the Accreditation Council for Continuing Medical Education and ACPE Standards for Commercial Support, all CME/CPE providers are required to disclose to the activity audience the relevant financial relationships of everyone in a position to control content of an educational activity. A relevant financial relationship is a relationship in any amount occurring in the last 12 months with a commercial interest whose products or services are discussed in the CE activity content over which the individual has control. Relationship information appears below:

Jill S. Burkiewicz, PharmD, BCPS, FCCP, has disclosed no relevant financial relationships.

Laura Boehnke Michaud, PharmD, BCOP, FASHP, has disclosed no relevant financial relationships.

Dr. Michaud discusses the unlabeled or investigational use of a commercial product.

Jane M. Pruemer, PharmD, BCOP, FASHP, has disclosed no relevant financial relationships.

Dr. Pruemer discusses the unlabeled or investigational use of a commercial product.

Sarah L. Scarpace, PharmD, BCOP, has disclosed the following relevant financial relationships:

  • Speaker - Merck, Millennium, Pfizer

Dr. Scarpace discusses the unlabeled or investigational use of a commercial product.

Curatio CME Institute

Matthew Horn, MD, Medical Director, has disclosed no relevant financial relationships.
Jonathan S. Simmons, ELS, Managing Editor, has disclosed no relevant financial relationships.

Postgraduate Healthcare Education

Susanne Batesko, RN, BSN, President, has disclosed no relevant financial relationships.

Disclaimer

The information presented at this activity is for continuing pharmacy education purposes only and is not meant to substitute for the independent medical judgment of pharmacists regarding diagnosis and treatment of a specific patient’s medical condition.

Unapproved Product Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. Curatio CME Institute, Postgraduate Healthcare Education, and Amgen do not recommend the use of any agent outside the labeled indications.

The opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of Curatio CME Institute, Postgraduate Healthcare Education, or Amgen. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.

Generic
Name
Trade
Name
Approved Use (if any) Unapproved/
Investigational Use
Anti-DKK1 N/A Investigational agent:
novel DKK1 inhibitor/Wnt
pathway stimulant
Treatment and prevention of
bone metastasis; treatment and
prevention of cancer therapy–
induced bone loss
Atrasentan Xinlay Investigational agent:
novel endothelin-A
antagonist
Treatment and prevention of
bone metastasis; treatment and
prevention of cancer therapy–
induced bone loss
AZD0530 N/A Investigational agent:
novel Src/Abl kinase
inhibitor
Treatment and prevention of
bone metastasis
Balicatib
(AAE-581)
N/A Investigational agent:
novel cathepsin K inhibitor
Treatment and prevention of
bone metastasis
Bortezomib Velcade Treatment of multiple
myeloma in patients who
have not responded to at
least one other agent
Treatment and prevention of
bone metastasis; treatment and
prevention of cancer therapy–
induced bone loss
Clodronate Bonefos Treatment of hypercalcemia of malignancy (outside the
United States; not
approved by the US FDA)
Treatment and prevention of bone metastasis
Denosumab Prolia
Xgeva
Treatment of osteoporosis
in postmenopausal women;
treatment of bone
metastasis from solid
tumors; not approved for
multiple myeloma
Prevention of bone loss;
prevention of bone metastasis;
treatment and prevention of
cancer therapy–induced bone
loss
Ibandronate Boniva Treatment and prevention
of osteoporosis in
postmenopausal women
Treatment and prevention of
bone metastasis
Ki26894 N/A Investigational agent:
novel transforming growth
factor-β kinase inhibitor
Treatment and prevention of
bone metastasis
L-000845704 N/A Investigational agent:
novel integrin inhibitor
Treatment and prevention of
bone metastasis
Odanacatib
(MK-0822)
N/A Investigational agent:
novel cathepsin K inhibitor
Treatment and prevention of
bone metastasis; treatment and
prevention of cancer therapy–
induced bone loss
Pamidronate Aredia Treatment of Paget’s
disease, hypercalcemia of
malignancy, and the
osteolytic bone metastases
of multiple myeloma and
breast cancer
Prevention of bone metastasis;
treatment of bone metastasis in
prostate cancer; prevention and
treatment of cancer therapy–induced
bone loss
Relacatib
(SB-462795)
N/A Investigational agent:
novel cathepsin K inhibitor
Treatment and prevention of
bone metastasis
Zoledronic
acid
Reclast
Zometa
Treatment and prevention
of osteoporosis in
postmenopausal women;
treatment to increase bone
mass in men with
osteoporosis; treatment and
prevention of
glucocorticoid-induced
osteoporosis in patients
expected to be on
glucocorticoids for at least
12 months, treatment of
Paget’s disease; treatment
of hypercalcemia of
malignancy; multiple
myeloma; solid tumors
with documented
metastasis to bone (in
conjunction with standard
antineoplastic therapy);
prostate cancer that has
progressed after hormonal
therapy
Prevention of bone metastases;
treatment and prevention of
cancer therapy–induced bone
loss



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